Anxiety & PTSD

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Kessler 10 Survey

These questions concern how you have been feeling over the past 30 days. Click on a circle below each question that represents how you have been.

1. During the last 30 days, about how often did you feel tired out for no good reason? *

2. During the last 30 days, about how often did you feel nervous? *

3. During the last 30 days, about how often did you feel nervous that nothing could calm you down? *

4. During the last 30 days, about how often did you feel hopeless? *

5. During the last 30 days, about how often did you feel so restless that you could not sit still? *

6. During the last 30 days, about how often did you feel depressed? *

7. During the last 30 days, about how often did you feel so sad that nothing could cheer you up? *

8. During the last 30 days, about how often did you feel worthless? *

Harvard Trauma Questionnaire

The following are the symptoms that people sometimes have after experiencing hurtful or terrifying events in their lives. Please read each one and decide how much the symptoms bothered you IN THE PAST WEEK.

1. Recurrent thoughts or memories of the most hurtful or terrifying events *

Not at all
A little
Quite a bit
Extremely

2. Feeling as though the event is happening again *

Not at all
A little
Quite a bit
Extremely

3. Recurrent nightmares *

Not at all
A little
Quite a bit
Extremely

4. Feeling detached or withdrawn from people *

Not at all
A little
Quite a bit
Extremely

5. Unable to feel emotions *

Not at all
A little
Quite a bit
Extremely

6. Feeling jumpy, easily startled *

Not at all
A little
Quite a bit
Extremely

7. Difficulty concentrating *

Not at all
A little
Quite a bit
Extremely

8. Trouble sleeping *

Not at all
A little
Quite a bit
Extremely

9. Feeling on guard *

Not at all
A little
Quite a bit
Extremely

10. Feeling irritable or having outbursts of anger *

Not at all
A little
Quite a bit
Extremely

11. Avoiding activities that remind you of the traumatic event or hurtful event *

Not at all
A little
Quite a bit
Extremely

12. Inability to remember parts of the most hurtful or traumatic event *

Not at all
A little
Quite a bit
Extremely

13. Less interest in daily activities *

Not at all
A little
Quite a bit
Extremely

14. Feeling as if you don't have a future *

Not at all
A little
Quite a bit
Extremely

15. Avoiding thoughts or feelings associated with the traumatic or hurtful events *

Not at all
A little
Quite a bit
Extremely

16. Sudden emotional or physical reaction when reminded of the most hurtful or traumatic event *

Not at all
A little
Quite a bit
Extremely

17. Feeling that you have less skills than you have before *

Not at all
A little
Quite a bit
Extremely

18. Having difficulty dealing with new situations *

Not at all
A little
Quite a bit
Extremely

19. Feeling exhausted *

Not at all
A little
Quite a bit
Extremely

20. Body pain *

Not at all
A little
Quite a bit
Extremely

21. Troubled by physical problems *

Not at all
A little
Quite a bit
Extremely

22. Poor memory *

Not at all
A little
Quite a bit
Extremely

23. Finding out or being told by other people that you have done something that you cannot remember *

Not at all
A little
Quite a bit
Extremely

24. Difficulty paying attention *

Not at all
A little
Quite a bit
Extremely

25. Feeling as if you are split into two people and one of you is watching what the other is doing *

Not at all
A little
Quite a bit
Extremely

26. Feeling unable to make daily plans *

Not at all
A little
Quite a bit
Extremely

27. Blaming yourself for things that happened *

Not at all
A little
Quite a bit
Extremely

28. Feeling guilty for having survived *

Not at all
A little
Quite a bit
Extremely

29. Without hope *

Not at all
A little
Quite a bit
Extremely

30. Feeling ashamed of the hurtful or traumatic events that have happened to you *

Not at all
A little
Quite a bit
Extremely

31. Feeling that people do not understand what happened to you *

Not at all
A little
Quite a bit
Extremely

32. Feeling others are hostile to you *

Not at all
A little
Quite a bit
Extremely

33. Feeling that you have no one to rely upon *

Not at all
A little
Quite a bit
Extremely

34. Feeling someone you trusted betrayed you *

Not at all
A little
Quite a bit
Extremely

35. Feeling humiliated by your experience *

Not at all
A little
Quite a bit
Extremely

36. Feeling no trust in others *

Not at all
A little
Quite a bit
Extremely

37. Feeling powerless to help others *

Not at all
A little
Quite a bit
Extremely

38. Spending time thinking why these events happened to you *

Not at all
A little
Quite a bit
Extremely

39. Feeling that you are the only one that suffered these events *

Not at all
A little
Quite a bit
Extremely

40. Feeling a need for revenge *

Not at all
A little
Quite a bit
Extremely

PTSD Diagnostic Scale

Trauma Screen

Have you ever experienced, witnessed, or been repeatedly confronted with any of the following: (click on all that apply) *

Serious, life threatening illness (heart attack, etc.)
Physical assault (attacked with a weapon, severe injuries from a fight, held at gunpoint, etc.)
Sexual assault (rape, attempted rape, forced sexual act with a weapon, etc)
Military combat or lived in a war zone
Child abuse (severe beatings, sexual acts with someone 5 years older than you, etc.)
Accident (serious injury or death from a car, at work, a house fire, etc.)
Natural disaster (severe hurricane, flood, earthquake, etc.)
None
Other (please specify)

Generalized Anxiety Disorder Scale

Over the last 2 weeks, how often have you been bothered by the following problems?

1. Feeling nervous, anxious, or on edge *

Not at all sure
Several days
Over half the days
Nearly every day

2. Not being able to stop or control worrying *

Not at all sure
Several days
Over half the days
Nearly every day

3. Worrying too much about different things *

Not at all sure
Several days
Over half the days
Nearly every day

4. Trouble relaxing *

Not at all sure
Several days
Over half the days
Nearly every day

5. Being so restless that it's hard to sit still *

Not at all sure
Several days
Over half the days
Nearly every day

6. Becoming easily annoyed or irritable *

Not at all sure
Several days
Over half the days
Nearly every day

7. Feeling afraid as if something awful might happen *

Not at all sure
Several days
Over half the days
Nearly every day

If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people? *

Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult